Inspection on 09/03/07 for Greenhill Grange Residential Home

This inspection was carried out on 9th March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Greenhill Grange Residential Home 09/03/09

Greenhill Grange Residential Home 22/02/06

Greenhill Grange Residential Home 28/09/05

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Greenhill Grange Residential Home Catherston Close Frome Somerset BA11 4HR Lead Inspector Loli Ruiz Unannounced Inspection 9th March 2007 10:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Greenhill Grange Residential Home DS0000064201.V330696.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Greenhill Grange Residential Home DS0000064201.V330696.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Greenhill Grange Residential Home Address Catherston Close Frome Somerset BA11 4HR Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01373 471688 Greenhill Grange Residential Home Ltd Mrs Gillian Patricia Twohig Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Greenhill Grange Residential Home DS0000064201.V330696.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd February 2006 Brief Description of the Service: Greenhill Grange is a purposefully adapted and extended home situated in a residential area of Frome. The home is set in its own very pleasant gardens, with car parking. The home has extensive countryside views from its communal rooms. Greenhill Grange is registered with the Commission for Social Care Inspection to provide care for up to 25 older people requiring assistance with personal care. This is a family run business with Mr Twohig and his son responsible for maintenance, gardening and driving duties. Mrs Twohig is the Registered Manager, and responsible for day-to-day management of the home. Mrs Twohig’s daughter, a registered nurse and manager of a nearby nursing home, also assists Mrs Twohig with staff training and management areas of the home. Greenhill Grange Residential Home DS0000064201.V330696.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was conducted as part of the annual inspection programme for the year April 2006 to March 2007 and took eight hours. As in the previous visit, Mrs Twohig, Proprietor/Registered Manager, was present throughout the inspection and her daughter joined us at the end of the day. Senior members of the care staff team were also involved in the inspection process, sharing their particular areas of work at the home with the inspector. A tour of the premises was made. Communal and private areas of the home seen were clean and tidy. A number of improvements had been made since the last inspection and one area was being refurbished. The majority of service users were in the communal areas of the home. The inspector spoke with many of them and had private conversations with a few in their rooms. Lunch was observed being served in the two dining areas and also some trays taken to bedrooms. The day’s menu was displayed and the meal was attractively served in good portions. The inspector observed that service users were treated in a dignified and appropriate caring manner. There was one exception to this that was discussed at some length with the manager. Service users looked well cared for and all those spoken with were very satisfied with the care and service they receive at Greenhill Grange. A number of service user and relative/carer comment cards had been received by CSCI. 8 cards returned from service users/ relatives and 7 cards from social/health professionals and staff. Positive feedback was heard via these cards as well as from 3 visiting relatives on the day of the inspection. Feedback was given to Mrs Twohig and her daughter at the conclusion of the inspection. The inspector would like to thank everyone at Greenhill Grange for their assistance. What the service does well: Greenhill Grange presents as a comfortable and well-maintained home with level access. All parts of the home are on ground level. The home benefits from outstanding open views and has well maintained grounds all around it. Since the last inspection the manager has improved the décor and soft furnishings on a number of rooms and refurbishment is continuing. Greenhill Grange Residential Home DS0000064201.V330696.R01.S.doc Version 5.2 Page 6 There is an appropriate admissions procedure in operation and the recording of care is generally good. The medication area is adequately managed. Meals are good. The care planning system and all recording systems are being improved and integrated, where previously records pertaining to one area were often in different booklets. There is a homely and relaxed atmosphere and service users are well catered for. An excellent range of activities for the residents has continued, which includes exercises, crafts, potted gardening and social events. Relatives involvement is invited and welcome. There is a stable and appropriately trained staff group to deliver care at the home. One of the senior staff is undertaking NVQ level IV. Positive feedback continues to be provided about the home by residents, their relatives, professionals and staff. What has improved since the last inspection? What they could do better: The home should ensure that all service users, including those in the home for a respite period, have a care plan. The manager should ensure that all hand written entries in the medicines administration record are supported by two signatures, including any over the counter remedies, and she should also provide residents with a lockable space for the safekeeping of valuables and medicines when self-medicating. The accidents form should be reviewed to make it clear all the necessary information that staff should report. The home should provide a portable hoist for assisting people up from the floor after a fall when uninjured. Greenhill Grange Residential Home DS0000064201.V330696.R01.S.doc Version 5.2 Page 7 The manager should develop and maintain a “ at a glance” training chart to readily evidence that mandatory training has been provided for all staff and indicating when updates are due. Communal bathroom and toilet floor coverings should preferably be washable and waterproof for optimum infection control. This should be considered when carpeted floor covering is replaced in bathrooms/toilets. The manager should consider the provision of an accessible shower room to provide choice, and also to meet the 1 to 8 bathing facilities ratio in the minimum standards, if at all possible. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Greenhill Grange Residential Home DS0000064201.V330696.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Greenhill Grange Residential Home DS0000064201.V330696.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 4, 5, 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users undertake an assessment of needs prior to coming to the home and are able to visit the home and assess the service before deciding to come in. EVIDENCE: The Statement of Purpose, Aims of the home and last inspection reports are available at the entrance of the home. The care records of three new service users were inspected. All had professional assessments, either by the social worker involved or the hospital, carried out prior to coming to the home. Two had also a pre-assessment carried out by the home. In the third case the assessment by the home had not been done until the admission day. However the person had visited the home prior to deciding to come in and had chosen this home from others seen. Greenhill Grange Residential Home DS0000064201.V330696.R01.S.doc Version 5.2 Page 10 Two of these service users provided very positive feedback of the home and confirmed having chosen it. The home does not cater for intermediate care. One person was in hospital and the manager was planning to visit the person to judge whether the home could meet the person’s needs or if a nursing assessment was necessary. Greenhill Grange Residential Home DS0000064201.V330696.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users benefit from an improved care planning system but one respite service user had no written plan of care. The management of medication protects residents with most areas seen well managed except that hand-written entries were not always supported by two signatures and service users are not provided with lockable spaces in their rooms as they should. Service users benefit from staff that respect their privacy and that treat them with warmth and respect with one exception that the manager is dealing with. EVIDENCE: Three care records inspected evidenced that two had care plans but one of them had not. The person was having respite but had been in the home for over two weeks. The person concerned explained to the inspector that the care in the home was excellent and indicated that his needs were very well met. Greenhill Grange Residential Home DS0000064201.V330696.R01.S.doc Version 5.2 Page 12 One of the senior staff is working towards NVQ IV and has undertaken the task of ensuring all residents have comprehensive care plans. Other care plans seen were completed to a good standard. Where significant areas of risk had been identified, these were included in the plan with instructions to staff. Day care records are kept in individual pockets within a file. Day records account well for daily events, including activities by each person. Significant events are highlighted and information informs the plans of care. Work is being undertaken to further improve the system and involving key workers in care plan reviews. The care recording system is new and plans seen were up to date from February 07 with reviews in March either completed or dated to have. Twice a year reviews are organised with relatives and anyone involved such as social workers. The manager plans to encourage service users to sign their care plan reviews at monthly intervals. Care records evidence visits from professionals and now include weight records and health monitoring previously recorded in separate books. The medication area was generally well managed. Controlled drugs storage and recording was well done and the balances and records of two persons inspected agreed. MAR sheets were generally well maintained. Items such as eye drops and Paracetamol when hand-written were not always supported by two signatures, as they should. There is a new medicines trolley and staff have begun to date creams, eye drops and medication on packets (other than those in the Nomad cassettes that are dated by the pharmacist) this is good practice. Residents should be provided with lockable space in their rooms for the safekeeping of valuables and medicines when self-medicating. Staff were observed assisting and relating with residents in gentle, caring and respectful manner. No private matter or assistance was carried out in public. The exception was one ancillary staff member whose manner did not accord with the ethos of the home. Mrs Twohig was already aware of this and was providing feedback to the staff member. Mrs Twohig understands that the person should not be in unsupervised contact with residents until improvement is brought about through supervision and training. Service users spoken with provided excellent feedback about the staff. The home caters for a few service users who are not able to provide feedback. Greenhill Grange Residential Home DS0000064201.V330696.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14,15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users continue to benefit from excellent opportunities for social activities, lifestyle choices and contact with relatives and friends. Service users are able to control their daily life and enjoy a nutritious diet. EVIDENCE: The excellent range of activities in the home has continued. The inspector met one of the two designated activities assistants. The care staff also help with activities. In addition the inspector met a previous carer who is now hired to provide one-to-one time and activities to persons who need more individual support and would not be able to join with group activities. Residents have the opportunity of joining a luncheon club in a local Church. Residents are involved in gardening and choosing plants they like to see in the gardens and patios. They had a project to encourage wildlife by putting together nesting boxes that they then give to relatives and friends. They are enabled to participate in local events. Seasonal festive dates are celebrated. There is monthly communion. On the day of the inspection residents had an assistant reading and discussing with them local news. In the afternoon there was a flower arrangement Greenhill Grange Residential Home DS0000064201.V330696.R01.S.doc Version 5.2 Page 14 competition. One resident was taken out for a little walk and later was encouraged with some artwork. Three visiting relatives provided very positive feedback. Positive feedback was also received from comment cards that CSCI had sent to relatives, professionals and staff in the home. All residents spoken with during the inspection indicated that living in the home was a positive experience and that staff were very good. Residents can choose when to get up and when to retire to bed. There is freedom of movement and of action. Some stayed in their rooms. The manager explained that the residents’ wishes and their happiness were of central importance in the home. There are residents meetings and a newsletter. Relatives are encouraged to participate in activities and celebrations. Information of daily events was well and clearly advertised on the notice boards. The main meal was advertised on the dining room board. Some residents ate in part of the smaller lounge and some took their meals in the bedrooms. There was soup and a fish pie with vegetables and potatoes. Residents said that the food was very good and freshly cooked. The cook was observed making pastry for individual tartlets. The meal observed was well served and in appropriate portions, depending on the person’s appetite. Residents said that options were available. The atmosphere in the dining rooms was convivial and staff were at hand to support those needing assistance. Greenhill Grange Residential Home DS0000064201.V330696.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected by the complaints procedure and by the recruitment practices and vetting practices in the home. EVIDENCE: The complaints procedure was available in the entrance hall together with the Statement of Purpose, Aims of the home and the last inspection report. There had been no complaints and all feedback received was positive. Residents said that they had no problems with raising any issue with the staff or management. The recruitment procedure in connection with two new staff was inspected and found well carried out. Staff do not start work until a clear POVA has been received. There is little staff movement in the home and the majority of staff have worked in the home for some time. There is a POVA policy and staff have received training however not all staff spoken with understood what POVA stood for although they appeared to have grasped the basis and said that they would take any issues of concern to the manager. Mrs Twohig’s daughter explained that she plans to support the home in introducing discussions about all policies and also about important developments in the industry, including topics of abuse and protection at staff meetings. Greenhill Grange Residential Home DS0000064201.V330696.R01.S.doc Version 5.2 Page 16 Foreign staff recruited through an agency have achieved NVQ equivalent status in their own countries, though the equivalency of this in practice was questionable judging by the attitude of one of them already discussed in outcome group 2. One file inspected included a valid work permit. Greenhill Grange Residential Home DS0000064201.V330696.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21,22, 23, 24, 25,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a well kempt, comfortable and clean home that is all on a ground floor level and from good access to well maintained gardens. Service users can personalise their private space and the majority of rooms have en-suite facilities. They also benefit from lockable doors to their rooms but have no lockable facilities for valuables and medicines in their bedrooms. Service users benefit from two assisted bathrooms and they would further benefit from a portable hoist and from an accessible shower facility. EVIDENCE: The home is all on one floor with good access to attractive and well-maintained patio and garden areas with outstanding views. The home was clean and free from odours. The home does not employ domestic staff but care staff do the cleaning. Carpets are of a domestic quality. Greenhill Grange Residential Home DS0000064201.V330696.R01.S.doc Version 5.2 Page 18 The inspector was told that the owner’s son shampoos them at regular intervals and staff clean spillages. There are two adapted baths with domestic carpets. There used to be showers but they were taken out. The manager was encouraged to consider providing one shower facility to introduce choice and meet the 1 bathroom per 8 residents standard. The home has no aid to assist with people who fall of the floor. 14 accidents that appear to have been falls had been documented for February with minor consequences. The accidents’ form in use should be improved to invite clearer documentation of what the accident actually was. This is recommended under NMS 38. The majority of rooms have en-suite facilities. All bedrooms have locks but rooms are not provided with lockable space for valuables. All rooms seen were fully personalised. The oldest part of the home was being refurbished. Since the last inspection the dining room and some communal areas have been redecorated and had new soft furnishings. The manager has placed notices inviting everyone to switch off lights when not in use. She assured the inspector that all areas remained safely lit in the dark hours to ensure that the safety of those with impair sight is not jeopardised in order to save energy. There is a good system in operation for the control of the spread of infection. Chemicals are locked away except for disinfectants in the cupboard in the staff’s office that the manager agreed to also lock away. The home has complied with the last recommendations made by the Environmental Health and by the Fire Officers. Good practices were observed in connection with the control of spread of infection, i.e. protective clothing available and in use, liquid soaps and paper towels, colour coded equipment and separate kitchen and general laundry. Greenhill Grange Residential Home DS0000064201.V330696.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a stable staff group, clear and well distributed roles, good recruitment practices and from a good skill mix. About 50 of the staff have NVQ qualifications or equivalent. EVIDENCE: Appropriate staffing levels have remained as evidenced by the staff on duty during the inspection and by the residents spoken with. Staff indicated that they had enough time to carry out their duties without stress and also had time to spend with residents. They also managed well to cover absences. Residents indicated that they did not need to wait for assistance and staff were always available to them. A senior member of staff is usually in charge of the home or a shift leader. The manager is also often available to lead staff. Three carers work with a senior in the morning and two during the afternoon. At night there is a senior plus a carer. The seniors have specific delegated management tasks for example one takes responsibility for allocation of the duty rotas. One of them is working towards NVQ IV. A copy of staff rota sent to CSCI does not indicate roles or length of shifts, however the original has roles colour-coded and the manager explained that Greenhill Grange Residential Home DS0000064201.V330696.R01.S.doc Version 5.2 Page 20 staff work three-day shifts and the night shift. Day shifts are 7 to 2 p.m. and 2 to 9 p.m. with a third person working 9-2. The night shift is 9p.m. to 7 a.m. Staff indicated that they have staff handovers although this is not reflected on the rotas. The rotas should be improved by the inclusion of the full shifts that people work. Records evidenced that staff have received training on all mandatory topics and a range of training DVDs have just been purchased for in-house training. The manager was encouraged to develop a training chart covering all mandatory topics and indicating when updates are due as an easy “at a glance” record. At present this information is in a number of books and personal records making the recording of evidence laborious and time consuming. This is recommended under NMS 38. There is a good induction procedure and the manager was encouraged to look also at the latest Common Induction booklet. The manager plans to introduce discussion about all minimum standards; developments in health and safety topics and in the care sector, including legal changes and POVA issues in staff meetings so that staff are better informed and become familiar with the terminology and news in the care sector. Greenhill Grange Residential Home DS0000064201.V330696.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,36,37,38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a well run home and from open and clear leadership. Records are kept, systems and procedures are maintained to ensure the health and safety of those living and working in the home. EVIDENCE: As explained in the last inspection report, the Registered Manager, Mrs Gillian Twohig has many years of experience managing a care home for older people. Mrs Twohig is responsible for the day-to-day management of the home and is supernumerary to the care staffing number. Mrs Twohig has an open and enabling management style that is beneficial to staff and service users. Greenhill Grange Residential Home DS0000064201.V330696.R01.S.doc Version 5.2 Page 22 Senior staff have a “can do” attitude to meeting standards. The manager delegates managerial roles to her seniors and also to her daughter who is a qualified nurse and manages her own nursing home. She provides a great deal of the training and guidance to staff. One of the senior staff is undertaking NVQ IV at present. Staff receive appropriate induction and supervision that is both formal and informal. The manager is working towards ensuring that this support is always documented 6 times a year for each of the staff members. Staff indicated that they felt well supported. All key maintenance and servicing records were inspected and found up to date. This included mandatory staff training and the manager was encouraged to develop an “at a glance” training chart. Insurance and registration documents were displayed. The manager has complied with recommendations made by the environmental health officer in the kitchen and also by the latest fire officer’s visit. Medication is checked regularly by the pharmacist. Only senior staff deal with medication and have received medication training. Recommendations are made with regards to the accident form used that need reviewing so that accidents reported have all necessary information. Greenhill Grange Residential Home DS0000064201.V330696.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 2 2 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 3 3 Greenhill Grange Residential Home DS0000064201.V330696.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP26 Good Practice Recommendations Communal bathroom and toilet floor coverings should preferably be washable and waterproof for optimum infection control. This should be considered when carpeted floor covering is replaced in bathrooms/toilets. Previous recommendation of the last inspection. All service users should have a plan of care. All hand-written entries in the MAR sheets, including those for over-the-counter remedies, should be supported by two signatures. The home should provide residents with lockable space for in their rooms for the safekeeping of medicines and valuables. 2. 3. OP7 OP9 Greenhill Grange Residential Home DS0000064201.V330696.R01.S.doc Version 5.2 Page 25 4. OP21 The manager should consider the possibility of providing an accessible shower room to introduce choice for residents and to meet the 1 to 8 residents ratio of bathing/shower facilities minimum standard. The home should have a portable aid to assist staff to move people from the floor after a fall. Staff rotas should record the hours worked in each shift by each staff. The accident’s form should be reviewed as at present does not ask staff to explain what the accident was and this is unclear in accidents reported. Accident forms should clearly indicate what the accident was; how and when it happened; who was involved; what the witnesses and consequences were and what action was taken to prevent further accidents from occurring. The manager should develop and maintain a “ at a glance” training chart to more readily evidence that mandatory training has been provided for all staff and indicating when updates are due. 5. 6. 6. OP22 OP27 OP38 Greenhill Grange Residential Home DS0000064201.V330696.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Greenhill Grange Residential Home DS0000064201.V330696.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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